EmblemHealth and its companies, (together referred to as EmblemHealth), arrange for the delivery of health care services in accordance with, and subject to, the terms of the certificates of coverage and benefit packages purchased either by our members or on their behalf. We do not directly provide these services or supplies. Rather, these services and supplies are provided by a network of contracted providers. The health care providers listed in the various provider directories who deliver health care services are not the employees or agents of our companies. EmblemHealth is not liable for any negligent act or omission by any of the providers listed in the directory, or any of their employees or agents, who may from time to time provide medical services to EmblemHealth members. EmblemHealth expressly disclaims any agency relationship, actual or implied, with any health care provider. Any decisions made by EmblemHealth concerning appropriateness of setting or whether any services or supply is medically necessary, pursuant to the certificate of coverage, will be deemed to be made solely for the purpose of determining whether benefits are due under the agreement between the member and EmblemHealth, and not for the purpose of recommending any medical treatment or nontreatment. EmblemHealth does not diagnose or provide treatment advice. EmblemHealth does not exercise any control or direction over the medical judgment or clinical decision of any health care provider listed in their directory and does not interfere with the physician-patient relationship between the provider and EmblemHealth member.
This provider manual links to websites as a convenience as well as an educational and informational service to our providers. These links are not intended to provide medical or professional advice. All medical information, whether from these links or from any other source, needs to be reviewed carefully by the practitioner. The opinions and information expressed therein are not necessarily EmblemHealth's. EmblemHealth does not guarantee or warrant that the links referenced in this manual, or any information therein contained, are complete, accurate, or up to date since the date of this manual's publication or last update.
